COVID Patient’s Miraculous Recovery From A Brain Hemorrhage

A Dire Situation

A 76 year old patient Dr. Meena was being treated for COVID-19 at Sagar Hospitals, Jayanagar. She was recovering well and was about to be discharged. However, on the day of her discharge, she had sudden massive intracranial bleed and became deeply comatose.

Although the survival chances were less, her sons agreed for her surgery. Dr Manmeet Singh Chhabra, Consultant Neurosurgeon at Sagar Hospitals didn’t delay further & performed her surgery.

To quote Dr Manmeet- “Apart from other factors like age and coagulation parameters, the prognosis and survival chances in intracranial hemorrhage depends mainly on the level of consciousness , also known as the Glasgow Coma Score (GCS) before surgery. In Dr Meena’s case, she rapidly slipped into a deep comatose state with a GCS of 4/15 and non-reacting pupils. This condition is known as descending transtentorial herniation which, in general, has a poor prognosis. It requires early diagnosis and prompt surgical intervention to prevent respiratory arrest and death”.

COVID-19 & Neurological Disorders

According to Dr Shobha Naidu, Consultant Physician at Sagar Hospitals, - “COVID-19 can cause a myriad of neurologic sequelae. According to a study, the incidence of intracranial hemorrhage (ICH) was found to be 0.7%. Although relatively uncommon among COVID-19 patients, ICH is associated with a high mortality rate.”

The Miraculous Recovery

Despite her age and one-sided bleeding, she showed remarkable recovery with preserved speech and intact limb movements. With physiotherapy and rehabilitation, she was on her feet soon. It was only with immediate and timely neurosurgical intervention; she recovered completely and was discharged from the hospital.

Dr Santosh Kumar, Consultant Neurologist, Sagar Hospital further explains, “COVID-19 induces inflammation of blood vessels (vasculitis) which is responsible for most of the complications including acute ischemic stroke and rarely, brain hemorrhage. During the course of her treatment, apart from ICH, she also developed a condition known as ‘Cerebral Vasospasm’ which is very rare but fortunately recovered with medications.”

A Heartfelt Message to the People

Dr. Manmeet Singh’s message to the people is, “Doctors across the world are doing their best and risking their own lives trying to save patients with COVID-19. Despite taking necessary precautions, the risk of transmission of infection while operating on a COVID positive patient is very high especially during use of high-speed drills for cranial surgery. However, doctors and hospital staff across the country are selflessly providing their services despite the risks. It is indeed satisfying and heartening to see someone in deep coma recovering so well after surgery. On the flip side, it is equally painful to see incidences of attacks on doctors and hospital staff when some patient expires despite all efforts.” Let us thank the brave doctors for selflessly providing their services and who face risks during the COVID-19 pandemic.

A Ray of Hope During COVID Times

The COVID-19 pandemic has led to organ transplants becoming the last option for hospitals as they are busy setting up covid care centers and ramping up their ICU’s to cater to Covid patients. A 42 year old CKD (Chronic Kidney Disease) patient was one of the many patient’s put on an endless waiting list for a kidney transplant. The burden of mal functioning kidneys & having to undergo haemodialysis twice a week caused her much distress.

A Gift of Life

Sagar Hospitals always believes in the preamble-Transplanting Organs from a beating heart, brain dead donor is one of the greatest gifts one can bestow upon society and mankind!

The Neurology doctors had declared a particular patient as brain dead and the patient’s family members had approached the hospital authorities to donate the deceased patient’s organs. The hospital staff applauded their selfless gesture and sprang into action.

The Sagar Hospitals Transplant Coordination Committee headed by Dr. (Major) Mahendra Kumar, Medical Director informed the Jeevasarthakathe Team (Zonal Coordination Committee of Karnataka) about the organ donation consent given by the deceased patient’s relatives.

After obtaining the necessary consent from the relatives, the organ retrieval teams discharged by Jeevasarthakathe, arrived at the hospital. The Operation Theater team sprung into action in coordinating the organ retrieval process. The kidneys were harvested for transplant at the hospital.

The Nephrology Team consisting of Dr. Aravind and Dr. Sanjeev. K Hiremath, the Transplant team headed by Dr. Dilip. C Dhanpal and Dr. Nagasubramanyam took over. For the kidney transplant, 7 potential recipients from all over the state were selected as per the list maintained by Jeevasarthakathe. All the potential recipients underwent HLA matching to ascertain their fitness for undergoing transplantation, out of which the 42 year old Recipient was best suited immunologically and was immediately prepped for the Renal Transplant.

The new protocol for Covid safety, entailed the donor, recipient and the entire surgical team to undergo immediate RT PCR. After harvesting the organs from the donor, two surgical teams one for the recipient surgery and one for Bench Surgery i.e., to make the kidney surgically optimum for the transplant was formed and surgeries were completed. The ultrasound Doppler done on table showed excellent vascular flow and good perfusion of the transplanted kidney.

The Rebirth

The Recipient was shifted to transplant ICU and monitored continuously. The team at the hospital took extra precautions keeping the covid protocols in mind. She was discharged a few days later and owes her new life to the experienced & dedicated team at Sagar Hospitals.

The whole transplant was possible without a hitch only by the combined team effort of the Neuro Surgical team headed by Dr. Murali Mohan, Neuro Intensivist Dr. Gayathri, Nephro-Uro team of doctors, the transplant coordinator, Operation Theater staff, Kidney Transplant Unit nurses and the Departments of Laboratory and Radiology.

Kudos to Team Sagar for having the courage, experience and the commitment to conduct this emergency transplant diligently during the COVID-19 pandemic.

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